Clinical Skills Observer Training
ROLE OF THE CLINICAL SKILLS OBSERVEREvaluate all candidates fairly and objectively
Clinical Skills Observer Training
CLINICAL SKILLS OBSERVER QUALIFICATIONS
Clinical Skills Observer TrainingAPPROVAL PROCESS• HCP CSO training is mandatory – training from other
testing vendors is not accepted• Trained by Test Site Coordinators• Training Includes:
• Training on local procedures for handling testing materials securely
• Review of CSO Training Powerpoint• Watching CSO Training video• Shadowing experience CSO during an exam
Clinical Skills Observer Training
APPROVAL PROCESS• After training is complete, the Test Site
Coordinator submits a CSO Request and supporting documentation to the state HCP office for approval.
• Approval letter and certificate are sent to the Test Site Coordinator to copy for test site records and then given to the evaluator
Clinical Skills Observer TrainingMAINTAINING “APPROVED” STATUS• CSOs must administer at least two clinical skills
exams per year• CSOs may be removed from the list for:• Inactivity• Change of employment• Lack of affiliation with an approved program• Expiration/loss of nursing license• Violating the confidentiality agreement
Clinical Skills Observer Training
MAINTAINING APPROVED STATUS• CSOs who jeopardize test security or engage
in misconduct will be permanently removed from the “approved” list.
• CSOs who are removed from the list for other reasons must retrain and resubmitted to the HCP office before testing
Clinical Skills Observer Training
HANDLING TESTING MATERIALS• Test site coordinator provides materials to
CSO on “as needed” basis.• CSO must handle testing materials following
state and local procedures • CSO must take care to prevent exposure of
test content and candidate personal information.
Clinical Skills Observer Training
HANDLING TESTING MATERIALS• CSOs may not:• Photocopy or reproduce test materials, OR• Sell or disclose the content of the tests to any
person or organization, OR• Teach students using testing materials, OR
Clinical Skills Observer Training
ADMINISTERING EXAMS• Must be administered and answered in
English – no translation • No resources allowed other than
information in exam packet• Exam is to be administered in one
uninterrupted session
Clinical Skills Observer Training
ADMINISTERING EXAMS• A CSO must evaluate all skills by a candidate
before evaluating another candidate• Candidates may not be rotated among CSOs
at skills stations• Candidates may not be rotated as a group
from one skill to another
Clinical Skills Observer Training
VOLUNTEERS/RESIDENTS• Skills can be demonstrated on a manikin, if
appropriate• CNAs and students in nurse aide training
programs cannot be volunteers/residents• Preferred: Healthcare providers or
students not be volunteers/residents
Clinical Skills Observer Training
MISCELLANEOUS• CSOs should not be instructors in nurse aide
training programs• RULE: If a CSO is an instructor, he/she cannot
administer the clinical skills exam to a student if he/she has had any role in that student’s training
• Test site coordinators have open access to testing at any time.
Clinical Skills Observer Training
CLINICAL SKILLS EXAM OVERVIEW• Several skills incorporated into a scenario• Designed to more closely replicate what
nurse aides encounter on the job• Contains critical and non-critical tasks
Clinical Skills Observer Training
CLINICAL SKILLS EXAM OVERVIEW• Four testing scenarios• Total LTC exam time– 1 hour, 15 minutes• 15 minutes for instructions and candidate and
volunteer/resident preparation• 1 hour for skills demonstration
Clinical Skills Observer Training
CLINICAL SKILLS EXAM MATERIALS1. Cover Sheet – completed by test site coordinator
prior to the exam2. Candidate Information pages
1. Scenario & Candidate Instructions2. Documentation Sheet
3. Volunteer/Resident Information – includes instructions and volunteer consent form
Clinical Skills Observer Training
CLINICAL SKILLS EXAM MATERIALS4. Clinical Skills Observer Information pages
1. Equipment List and CSO Instructions2. Scenario & Candidate Instructions3. Documentation Sheet
5. Clinical Skills Examination Evaluation Grid - marked by the CSO as the candidate performs tasks
6. Clinical Skills Score Sheet – completed by the test site coordinator
Clinical Skills Observer Training
CRITICAL SKILLS
1. General in nature2. Requires candidate to demonstrate safety
and infection control at all times when performing skills
3. Candidate must measure vital signs accurately
Clinical Skills Observer Training
CRITICAL SKILLS
• CSO marks tasks related to safety and infection control
• Test site coordinator determines whether or not the candidate measured vital signs within acceptable margins of error
Clinical Skills Observer Training
NON-CRITICAL SKILLS – 80% Accuracy Required
• Tasks related to performing skills in the scenario
Clinical Skills Observer Training
PREPARING THE EXAMINATION AREA
• Administered in care-giving situation or a laboratory setting that has access to running water and closely resembles the environment in which nurse aides function
• All equipment and supplies provided by the test site
Clinical Skills Observer Training
PREPARING THE EXAMINATION AREA• Supplies are listed in the CSO Information in
the clinical skills exam packet• CSO does not gather the supplies and
equipment for the exam, but must make sure that everything is accessible to the candidate and the candidate knows where to retrieve them
Clinical Skills Observer TrainingPREPARING THE CANDIDATE & VOLUNTEER/RESIDENT• Remind both that cell phones and electronic devices
are not permitted; allow them to secure if needed• Confirm the candidate’s identify as shown on the
cover sheet• Provide candidate with sheets on packet labeled
“Candidate Information” to review while preparing the volunteer/resident
Clinical Skills Observer TrainingPREPARING THE VOLUNTEER/RESIDENT• Take the volunteer/resident to testing area and
instruct him/her to remove shoes, put on a hospital gown over his/her clothes, and sit in the hospital bed
• Review the volunteer/resident Information & answer questions
• Have volunteer/resident sign information sheet/consent form
Clinical Skills Observer Training
PREPARING THE CANDIDATE• Bring candidate into testing area and review
the Scenario & Candidate Instructions together
• Candidate may take notes on the information sheet and refer to the information sheet and his/her notes during the examination
Clinical Skills Observer Training
PREPARING THE CANDIDATE• CSO demonstrates how to operate the
bed, wheelchair, and other equipment (if needed)
• Answer candidates questions, if any.• Candidate and CSO each sign their
respective copies of the Information Sheet.
Clinical Skills Observer Training
ADMINISTERING THE EXAM• When the candidate is ready to begin the
exam, the CSO will mark the start time on the evaluation grid.
• The CSO must mark each task as it is performed
• An explanation must be provided for all tasks marked “No”
Clinical Skills Observer Training
ADMINISTERING THE EXAM• Although the scenario and evaluation grid
are in a logical order, the candidate can go out of sequence as long as he/she observes standard precautions and does not endanger the volunteer/resident, the CSO, or the candidate.
Clinical Skills Observer Training
ADMINISTERING THE EXAM• If a candidate makes mistake or forgets a
task, he/she may correct and re-demonstrate the skills as long as the error or omission is noted before the exam is finished and the allotted time for the exam is not exceeded.
Clinical Skills Observer Training
ADMINISTERING THE EXAM• Candidates are required to demonstrate
hand washing the first time it is needed in the exam; in all subsequent instances that require hand hygiene, the candidate need only verbalize that he/she would was hands or use hand sanitizer
Clinical Skills Observer TrainingADMINISTERING THE EXAM• During the exam, the CSO may give the candidate up to
three attempts to obtain the correct vital signs measurements.
• This is the only time when the CSO may provide feedback to the candidate
• If multiple blood pressure readings are required, the candidate must observer or verbalize, without prompting, the correct waiting time between attempts.
Clinical Skills Observer Training
ADMINISTERING THE EXAM• The CSO may not prompt the candidate,
answer questions from the candidate about a skill, or indicate whether a skill was performed correctly.
• The CSO may periodically remind the candidate that the resident/volunteer is wearing a hospital gown
Clinical Skills Observer Training
ADMINISTERING THE EXAM• If the candidate does anything during the
exam that compromises infection control or resident safety, the CSO will mark that task “no” and provide an explanation of the action(s) that were incorrectly (or not done at all)
Clinical Skills Observer Training
FINISHING THE EXAM• CSO marks the end time on the evaluation
grid• CSO collects all pages of the clinical skills
examination packet – the candidate may not take the scenario or instruction sheet!
• The CSO will advise the candidate on how his/her results will be communicated
Clinical Skills Observer Training
FINISHING THE EXAM• All clinical skills exam packets (used or
unused) must be returned to the test site coordinator - CSOs may not keep unused packets for use at a later time